Who Is Entity (4)
The emergency room I arrived at was packed wall to wall with patients.
The familiar smell of feces, masked by an equally familiar smell of antiseptic, stung my nose.
The ER was already so crammed with patients, guardians, and medical staff that there wasn't a square inch of floor to spare.
Jeong-uk shouldered his way through the crowd and headed for Zone A.
There he found our department's resident in the middle of emergency treatment.
“Soyeon, I'm here.”
“You came, Professor!”
Relief was plain in her voice.
Normally, the cardiology ER night shift falls to the most junior attending on call, but since I had the night off, she'd been the one holding down the fort. Which meant she'd just enjoyed the rare experience of playing attending while being neither a professor nor even an associate.
“The patient you just called about?”
“Yes. We gave intralipid, the vitals stabilized, and she's under observation now.”
“Let's take a look at her EKG.”
“Of course.”
Thankfully, there was no arrhythmia.
It meant there was no need to gamble on lidocaine.
“Good work, Soyeon. You're the one who saved this person.”
“I didn't do anything, Professor. It was all you.”
“I wasn't even here.”
I shook my head.
“And with TCA overdose, the initial management is everything. You saved her, so feel free to brag about it.”
A proud smile bloomed across Soyeon's face.
It didn't last even a few seconds.
“Oh, right—by the way, is our side holding up okay?”
“Not really. There's a strange surge of overdose patients tonight.”
Her expression hardened.
So she'd noticed something was off too—well, third year, after all.
In South Korea, the most common methods of suicide attempt are hanging first, jumping second. Those two account for seventy to eighty percent of cases, with the remaining twenty percent or so split among drugs, pesticides, and gas inhalation.
That's the standard statistic.
But tonight was different.
The number of patients attempting suicide by drug overdose was far from negligible.
Just as I thought.
I murmured to myself.
steers each victim toward whatever method is easiest for them, based on where they are and when they read it.
I myself was living proof.
In my case, there happened to be no drug in the house lethal enough to kill me, so I was steered toward throwing myself off the balcony.
But what about people who already kept medication at home?
For them, opening a pill bottle would have been far easier than opening a window.
None of this was a matter of people's choices.
That difference was what had warped the statistics.
“Alright, got it. Then I'll go see the other overdose patients—”
Beeeep—!
Before I could even finish the sentence, a shrill tone erupted from Bed A-11.
It cut through every noise in the emergency room and drove straight into my eardrum.
The notification sound no doctor ever wants to hear—a physician's nightmare made audible.
The sound that only rings when a human heart has stopped. The sound every doctor dreads above all others.
Beeeep—
“Patient's in arrest!”
The intern holding the arterial line beside the bed shouted in desperation.
“Patient's in arrest!”
The intern's cry cut across the emergency room.
Bed A12.
The young man lying in it had his eyes closed, peaceful as the dead.
Beside him, a woman who appeared to be his mother was wailing.
“Minseok! Minseokkk! Oh my god—!”
The woman's hands shook her son's body.
But the son didn't respond, and the waveform on the monitor he was connected to traced a chaotic, tangled curve.
“Doctors! Our Minseok! Please, save our Minseok!”
“Arrest in A12!!!”
Next to the guardian, the intern was shouting hard enough to tear his throat.
Yet despite their anguished cries, no one moved toward that bed.
At most, a few interns grabbed the EKG machine and the LUCAS device—a mechanical chest-compression unit—and started running over.
But other residents grabbed hold of them.
“Oh no, oh nooo!”
The din that had filled the emergency room subsided as if by magic, leaving only the guardian's weeping as the sole sound.
And in that silence, the emergency medicine resident holding the interns back whispered:
“Intern, we don't do CPR during Code Black.”
The silence of the ER seemed to affirm the words.
Just as the resident said, in a mass-casualty disaster like this, CPR is not performed.
To deliver effective CPR to a patient in cardiac arrest, you need at least two or three skilled providers rotating through chest compressions, plus additional staff assigned to intubation and drug administration.
For dozens of minutes at a time.
With that manpower and that time, you could save six more patients.
And so, in a disaster situation, CPR is not performed.
It's cruel, but disaster medicine has evolved not to maximize any individual's happiness—it has evolved to maximize the public good.
“Doctors! Doctors!!”
The guardian wailed as though the world were ending, while the intern beside her dithered, frozen, unable to move in any direction.
The other medical staff watching the scene turned their heads away from that bed.
“Doctors, please—”
That was when it happened.
A man's voice—something close to a roar—rang out across the room.
“What are you all waiting for?! Move!!”
Every gaze in the room snapped toward the voice.
A man in an attending's white coat was half-climbing onto the bed, desperately compressing the patient's chest with his own two hands.
Fingers interlocked, textbook form, his entire body weight driving down with each compression.
The sight planted a single question in every staff member's mind.
Why is the professor doing compressions?
Compressions were the residents' territory.
Unless the department was desperately short-handed, burning that kind of stamina was a resident's job.
A professor is supposed to conserve his strength—diagnose the patient's condition, predict the prognosis, plan the next intervention.
And yet this young attending was doing the residents' work himself.
As he compressed, the name tag slipped from the professor's chest.
Tap.
The badge landed at the guardian's feet.
[Clinical Professor of Cardiology — Lee Jeong-uk]
Professor Lee Jeong-uk bellowed at the people still standing frozen in place.
“Internal medicine, are you all asleep?! This isn't a trauma patient—it's an overdose! Do I need to spell it out for you?!”
At his shout, the internal medicine trainees finally began to move.
Why is CPR taboo during a Code Black?
Partly because resources are scarce—but mostly because even when you commit those resources, the odds of survival are so low.
Overdose arrests were the exception.
Administer the antidote, compress for a few short minutes, and the outcome often improves dramatically.
And above all, internal medicine had a brief window of free hands right now.
Starting from Jeong-uk's shout, every available internal medicine trainee converged on that one patient.
“AED result?!”
“V-Fib—ventricular fibrillation!”
“Prepare to defib—clear back! Charging! Shock!”
Thud!
The defibrillator jolted the patient's body off the bed.
“Two hundred joules! Charging! Shock!”
Thud!
“Rhythm's back!”
The waveform had returned.
The heart was beating regularly again.
Wiping away his sweat, the professor spoke to the third-year resident.
“Soyeon. Open the resuscitation room. We're putting in a pacemaker.”
“I'm sorry—right now?”
Soyeon, the most senior internal medicine trainee in the ER, asked in bewilderment.
“But we're in Code Black... a pacemaker, now? We don't know when more patients will come in—”
“A temporary pacemaker. We'll be done in fifteen minutes. I'll take responsibility, so just open it. Even if there's a problem, it won't come down on you.”
“Y-yes... yes, Professor!”
The resident sprinted out of the ER.
Having brought one heart back from the dead, Jeong-uk yanked out a fistful of rough paper towels.
And as he wiped the sweat from his brow, he thought:
Not a single person dies inside this hospital. Not one.
The most terrifying thing about this Entity was what happened after the primary victims died.
The moment efficiency won out, the precious loved ones of those primary victims would become the next patients, arriving back at these doors one after another.
But put another way—
If the primary victims don't die, it ends here.
Jeong-uk had no confidence he could save everyone who had read the novel.
But at least the people who had crossed this hospital's threshold—he intended to save every last one of them, somehow.
Realistically impossible, of course.
Even so, leaving life and death at the mercy of that Entity's whims was something Jeong-uk found thoroughly distasteful.
Having wiped away the last of the sweat, he picked up his phone and placed a call somewhere.
♪ For loving you~ ♪ — a hopelessly outdated oldie rang out briefly,
then a weary voice came through the receiver.
“Yes, Department Chair. Yes. What happened with what I asked you about?”
[I sent an official request to the Communications Commission through the Medical Association—but is this really okay?]
“Life's a gamble, isn't it? If my judgment's wrong, I'll take responsibility and rot in prison for the rest of my days.”
[It's not just your life on the line, punk. ...Well. A man who's published in the Nancet isn't likely to be talking out of his ass. And I do owe you one.]
“You won't regret this choice either, Department Chair.”
Jeong-uk snickered and hung up.
Call ended, he opened the novel again.
[This novel has been removed for violating broadcasting and communications regulations.]
“There it is. The nation of censorship. When it comes to this, they're impressively fast.”
Even before reaching the hospital, his first priority had been contacting the Medical Association.
As long as the Entity known as remained online as a novel, anything he did in the ER was pouring water into a bottomless barrel.
To get through this night intact, the root cause had to be eliminated first.
So he had used the Department Chair's connections to reach the Medical Association, and through them, filed a direct removal request with the Communications Commission.
Fortunate timing, too—the novel was already being reported as a problem nationwide.
There had been survivors. People who, like Jeong-uk, had been a step from jumping or swallowing pills when a random notification popped up on their screens.
For something so dangerous, the Entity's weakness is surprisingly simple.
All you had to do was obscure the screen in any way before completing the choice.
An unexpected phone call. A preset alarm going off.
Or, as in Jeong-uk's case, a game screen taking over.
Among the thousands of victims, those who'd been saved that way were now feverishly reporting the novel.
And once an official letter arrived bearing the names of a university professor and the Medical Association, the Communications Commission didn't take it as a joke—it moved fast.
And so, five hours after it went up, the novel was deleted.
Jeong-uk recalled the final view count he'd checked.
Views:3,148
Thank God it was the middle of the night.
If the censorship had been even a little later—if the novel had gone up in the morning instead—
The situation would almost certainly have spiraled far beyond control.
I don't know if "fortunate" is the right word, though.
Jeong-uk swallowed the bitterness lingering on the tip of his tongue.
Too many people he hadn't saved.
Once tonight passed, the news would deliver the statistics—the dead and the living.
Jeong-uk figured it would come out to roughly fifty percent.
The drug overdose cases had decent survival rates, but the others, the majority...
If I had moved faster. If I'd asked them to take the novel down sooner.
It had been entirely foreseeable.
If, instead of standing alone on the balcony gathering my scattered mind right after reading the novel, I had acted first—
In his head, one hypothetical after another chained itself together, on and on, each one a choice he could have made.
“Professor! The procedure room's ready!”
“Oh—coming.”
The resident's voice yanked him back to reality.
Jeong-uk turned his back on the bed the patient had occupied moments ago.
And walked toward the resuscitation room where the patient now lay.
There was no time for self-recrimination.
The darkest hour of dawn was not yet over.
Repentance could wait until the sun came up.
He headed for the resuscitation room.
To save one more person, and one more after that.
And—
I can't strike you down. So I'll beat you like this instead.
To win against the Entity.
The night from hell ended, and morning arrived.
[Code Black lifted. Code Black lifted.]
“Haaah... hah...”
In a corner of the emergency room, a first-year internal medicine resident sat slumped against the wall, utterly spent, and checked his wristwatch.
Six o'clock.
“Aaah... my shift's over...”
“Night duty on New Year's...”
“Wait, we actually have to come back to work today? For real?”
Just as the residents began lapsing into collective delirium—
The violent dawn behind us,
I stood at the entrance of the emergency room.
Arms crossed, legs trembling, the cold pre-dawn wind hitting my face full on.
The exhaustion came rushing in late, the price of burning through the night.
But I didn't consider it over yet.
Behind me, Song-woo, a second-year internal medicine resident, approached.
Fatigue was written plainly across his face too.
“Um... Professor, I'm sorry.”
“For what?”
“For trying not to do CPR on the overdose patient.”
“Ah, that.”
Pff.
A hollow laugh escaped my mouth.
“I understand. You were scared of losing other patients by trying to save that one, right?”
Honestly, the judgment of the people in that ER hadn't been entirely wrong.
There is no right answer in disaster medicine.
Even for an overdose, when you don't know whether the next patient will walk through the door, making that call isn't easy.
If the outcome turned out badly later, you could easily find yourself wearing a disciplinary anklet.
In my case, I knew the source novel would be deleted and no more patients would come—and more than anything, I knew there was something I feared more than prison. That's why I could act boldly.
The world's already gone to hell. What's prison compared to that?
Honestly, my attitude these days is let whatever happens, happen.
Back then, all I was thinking about was stopping the secondary casualties.
So I had no intention of scolding the residents.
By every standard and every piece of knowledge up to now, their response hadn't been wrong.
I patted the sulking Song-woo on the shoulder to console him.
“Decisions like that are supposed to be made by attendings like me. You're all still in the middle of learning, so there's no need to mope. If anyone gets a disciplinary anklet, it'll be me—I'll make sure it's never you.”
“Professor...!”
Song-woo looked up at me with eyes full of gratitude.
Yes. Respect me just like that.
That way, the odds of a burnt-out resident (grad student) driving a knife into my back in this collapsing world go down, don't they?
Having thus managed public opinion in the cracks between crises, I glanced at the haggard residents and suddenly remembered something.
“Oh, right. Didn't the other attendings tell you?”
“Tell us what?”
“This is just the beginning. Once surgery and the ER finish stabilizing the emergency patients, they become ours. What do you think cardiology's job is?”
“Ah...”
The color drained from Song-woo's face.
It was the moment a second-year resident, clinging to endurance on nothing but his seniority, finally broke.
For the record, the third-years—the de facto seniors of internal medicine—had long since headed to the ICU without a word being said.
They were up there caring for patients who'd made it through surgery and stabilized.
Three years of hard-earned education: there is no rest for us.
Having sunk the second-year, I went back to staring at the entrance, arms crossed.
Dawn was breaking.
Some would call it a symbol of hope. To me, it rang very differently.
A first-year who'd been warily watching my face piped up with a question.
“Professor, are more new patients coming?”
“No.”
“Then why are you standing at the entrance? You could at least nap in the on-call room.”
“There are no patients yet—but there will be. It's six o'clock, isn't it?”
“...Sir?”
“You slept through my lecture, didn't you?”
“...”
The first-year averted his eyes.
Six o'clock.
The hour when cardiology turns into hell.
“Cardiac arrests and arrhythmias cluster around this time. Some are found by family members who woke up in the night—but this is also the hour when, just after waking, cortisol and the autonomic nervous system are at their most unstable.”
“Ah...”
Before I'd even finished speaking, the phone at the ER desk rang out shrilly.
“Yes, Castrato Hospital Emergency Department.”
The ER nurse who answered fell silent for a moment, then craned her head around the room.
Catching my eye, she cupped her hand over the receiver's mouthpiece and said to me:
“Professor, it's a cardiac arrest. Does internal medicine have a bed open?”
“Two patients discharge today. We'll take it.”
“Understood.”
The nurse relayed that a bed was available.
Naturally, the faces of the internal medicine residents who'd overheard darkened.
“Ugh.”
“Come on, up. We work.”
“Aaah...”
“Don't you dare talk about dying. I'm dead on my feet too.”
As I sized up the incoming patient, an intuition settled over me.
After a night this violent, there would be no returning to normal life before today's sun had fully risen.
And—
The world isn't going back to the way it was, is it.
Watching the news report last night's chaos on the television mounted in the emergency room,
we had no choice but to accept the world that had changed.